PT  - JOURNAL ARTICLE
AU  - Ashley E. Kim
AU  - Elisabeth Brandstetter
AU  - Naomi Wilcox
AU  - Jessica Heimonen
AU  - Chelsey Graham
AU  - Peter D. Han
AU  - Lea M. Starita
AU  - Denise J. McCulloch
AU  - Amanda M. Casto
AU  - Deborah A. Nickerson
AU  - Margaret M. Van de Loo
AU  - Jennifer Mooney
AU  - Misja Ilcisin
AU  - Kairsten A. Fay
AU  - Jover Lee
AU  - Thomas R. Sibley
AU  - Victoria Lyon
AU  - Rachel E. Geyer
AU  - Matthew Thompson
AU  - Barry R. Lutz
AU  - Mark J. Rieder
AU  - Trevor Bedford
AU  - Michael Boeckh
AU  - Janet A. Englund
AU  - Helen Y. Chu
AU  - on behalf of the Seattle Flu Study Investigators
TI  - Evaluating Specimen Quality and Results from a Community-Wide, Home-Based Respiratory Surveillance Study
AID  - 10.1101/2020.12.07.415653
DP  - 2020 Jan 01
TA  - bioRxiv
PG  - 2020.12.07.415653
4099  - http://biorxiv.org/content/early/2020/12/08/2020.12.07.415653.short
4100  - http://biorxiv.org/content/early/2020/12/08/2020.12.07.415653.full
AB  - Introduction While influenza and other respiratory pathogens cause significant morbidity and mortality, the community-based burden of these infections remains incompletely understood. The development of novel methods to detect respiratory infections is essential for mitigating epidemics and developing pandemic-preparedness infrastructure.Methods From October 2019 to March 2020, we conducted a home-based cross-sectional study in the greater Seattle area, utilizing electronic consent and data collection instruments. Participants received nasal swab collection kits via rapid delivery within 24 hours of self-reporting respiratory symptoms. Samples were returned to the laboratory and were screened for 26 respiratory pathogens and a human marker. Participant data were recorded via online survey at the time of sample collection and one week later.Results Of the 4,572 consented participants, 4,359 (95.3%) received a home swab kit, and 3,648 (83.7%) returned a nasal specimen for respiratory pathogen screening. The 3,638 testable samples had a mean RNase P CRT value of 19.0 (SD: 3.4) and 1,232 (33.9%) samples had positive results for one or more pathogens, including 645 (17.7%) influenza-positive specimens. Among the testable samples, the median time between shipment of the home swab kit and completion of laboratory testing was 8 days [IQR: 7.0-14.0].Discussion Home-based surveillance using online participant enrollment and specimen self-collection is a feasible method for community-level monitoring of influenza and other respiratory pathogens, which can readily be adapted for use during pandemics.